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Hospitals turn away more ambos

Julia Medew

MELBOURNE'S overflowing hospitals are turning ambulances away at a far greater rate than they publicly report, forcing paramedics to care for sick and injured patients longer than they should.

Ambulance Victoria data reveals that while Melbourne's largest 14 hospitals were on bypass for the equivalent of 76 days between July 2009 and April this year, they also used the Hospital Early Warning System (HEWS) for 165 days between them.

The early warning system allows hospitals to tell ambulances they are nearly full and that all non-urgent patients should go elsewhere. Doctors say it is a defacto form of bypass that helps hospitals meet a state government benchmark that says they should limit bypass time to less than 3 per cent of each year.

The data, released to the Coalition under freedom of information laws, shows that Monash Medical Centre used bypass and the early warning system more than any other hospital, clocking up 40 days over the 10 months. This meant the hospital diverted ambulances for 13 per cent of the time, well above the government's 3 per cent target. Royal Melbourne Hospital was on bypass and HEWS for 25 days or 8.5 per cent of the time. It was followed by the Austin, Frankston and Dandenong hospitals, which all used the systems for 22 days or 7.5 per cent.

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Ambulance Employees Australia state secretary Steve McGhie said the figures were not surprising because paramedics had increasingly found themselves caring for patients for hours at a time while they queued outside Melbourne's overcrowded hospitals.

He said if anything, hospitals were not going on bypass and HEWS enough because paramedics were often lining up outside hospitals when there was no message for them to go elsewhere. ''The hospital system is clearly not keeping up with demand,'' Mr McGhie said.

A recent survey of 124 Victorian emergency department doctors conducted by the Australasian College for Emergency Medicine revealed that hospital chiefs were not allowing doctors to activate bypass when they were full because they did not want to fail the government's benchmark.

Seventy per cent of the doctors said this had been a problem for them and one said it had cost lives because ambulances were delivering seriously ill patients to overcrowded emergency departments that were unable to care for them.

Victorian chairman of the college, Dr Simon Judkins, said HEWS was very similar to bypass and had a minimal effect on reducing demand for hospital care. He said when one hospital activated either of the systems, it tended to have a domino effect of causing other hospitals to follow, leaving ambulances with limited choice.

''It tends to filter through the system,'' he said. ''The only thing that will help this is more beds across the system … We need to keep moving patients out of the emergency departments.''

Coalition health spokesman David Davis said the government had mismanaged the health system and was trying to cover up the true extent of the damage by hiding HEWS data. The Victorian government has promised to add 497 beds during the next four years on top of those in the health reform deal.